Left-to-right differences of regional cerebral oxygen saturation and oxygen extraction in preterm infants during the first days of life.
In a prospective study, we monitored simultaneously left and right parieto-frontal-cerebral oxygen saturation (rScO2) and cerebral fractional tissue oxygen extraction (cFTOE) using near-infrared spectroscopy in 36 very preterm neonates during the first 3 d of life. Simple regression analysis showed a close correlation between left and right rScO2 (r = 0.89, p < 0.01) and cFTOE (r = 0.88, p < 0.01), respectively. The Bland and Altman-determined limits of agreement found overall limits of agreement of -8.5 to +9.5% and of -0.10 to +0.093% between left and right for rScO2 and for cFTOE, respectively. However, we found that during stable systemic oxygenation (i.e., arterial oxygen saturation [SaO2 between 85 and 97%]) the limits of agreement between left and right improved from -7.8 to +8.2% and -0.088 to +0.084 for rScO2 and cFTOE, respectively (all p < 0.05). We conclude that bilateral near-infrared spectroscopy-measured rScO2 and cFTOE can reveal differences up to 10% between left and right hemisphere, especially during unstable arterial saturations, which may indicate uneven cerebral oxygenation.
Lemmers
Petra M A
PM
Department of Neonatology, University Medical Center/Wilhelmina Children's Hospital, 3584 EA Utrecht, The Netherlands. p.lemmers@umcutrecht.nl
van Bel
Frank
F
D001921:Brain / Q000098:blood supply / Q000378:metabolism*; D002560:Cerebrovascular Circulation; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared / Q000295:instrumentation; D013997:Time Factors; D014159:Transducers
D010100:Oxygen